JMI Laboratories, North Liberty, Iowa, USA.
J Clin Microbiol. 2013 Aug;51(8):2608-16. doi: 10.1128/JCM.00863-13. Epub 2013 Jun 5.
Isavuconazole is a new broad-spectrum triazole with a favorable pharmacokinetic and safety profile. We report the MIC distributions for isavuconazole and 111 isolates of Candida (42 Candida albicans, 25 Candida glabrata, 22 Candida parapsilosis, 14 Candida tropicalis, and 8 Candida krusei isolates), as determined by Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) broth microdilution (BMD) methods. Also, the relative activities of isavuconazole, itraconazole, fluconazole, posaconazole, voriconazole, and the three echinocandins were assessed against a recent (2011) global collection of 1,358 isolates of Candida spp., 101 of Aspergillus spp., 54 of non-Candida yeasts, and 21 of non-Aspergillus molds using CLSI BMD methods. The overall essential agreement (EA) (±2 log2 dilutions) between the CLSI and EUCAST methods was 99.1% (EA at ±1 log2 dilution, 90.1% [range, 80.0 to 100.0%]). The activities of isavuconazole against the larger collection of Candida spp. and Aspergillus spp. were comparable to those of posaconazole and voriconazole; the MIC90 values for isavuconazole, posaconazole, and voriconazole against Candida spp. were 0.5, 1, and 0.25 μg/ml and against Aspergillus spp. were 2, 1, and 1 μg/ml, respectively. Isavuconazole showed good activities against Cryptococcus neoformans (MIC90, 0.12 μg/ml) and other non-Candida yeasts (MIC90, 1 μg/ml) but was less potent against non-Aspergillus molds (MIC90, >8 μg/ml). Isavuconazole MIC values for three mucormycete isolates were 4, 1, and 2 μg/ml, whereas all three were inhibited by 1 μg/ml posaconazole. Isavuconazole demonstrates broad-spectrum activity against this global collection of opportunistic fungi, and the CLSI and EUCAST methods can be used to test this agent against Candida, with highly comparable results.
伊曲康唑是一种新型广谱三唑类药物，具有良好的药代动力学和安全性特征。我们报告了伊曲康唑和 111 株念珠菌（42 株白色念珠菌、25 株光滑念珠菌、22 株近平滑念珠菌、14 株热带念珠菌和 8 株克柔念珠菌）的 MIC 分布，这些菌株是通过临床和实验室标准协会（CLSI）和欧洲抗菌药物敏感性试验委员会（EUCAST）肉汤微量稀释（BMD）方法确定的。此外，还使用 CLSI BMD 方法评估了伊曲康唑、酮康唑、氟康唑、泊沙康唑、伏立康唑和三种棘白菌素对最近（2011 年）收集的 1358 株念珠菌属、101 株曲霉属、54 株非念珠菌属酵母和 21 株非曲霉属霉菌的相对活性。CLSI 和 EUCAST 方法之间的总体基本一致（EA）（±2 倍稀释）为 99.1%（±1 倍稀释的 EA，90.1%[范围，80.0%至 100.0%]）。伊曲康唑对更大的念珠菌属和曲霉属的活性与泊沙康唑和伏立康唑相当；伊曲康唑、泊沙康唑和伏立康唑对念珠菌属的 MIC90 值分别为 0.5、1 和 0.25μg/ml，对曲霉属的 MIC90 值分别为 2、1 和 1μg/ml。伊曲康唑对新型隐球菌（MIC90，0.12μg/ml）和其他非念珠菌属酵母（MIC90，1μg/ml）具有良好的活性，但对非曲霉属霉菌的活性较弱（MIC90，>8μg/ml）。伊曲康唑对 3 株毛霉属分离株的 MIC 值分别为 4、1 和 2μg/ml，而 1μg/ml 的泊沙康唑均可抑制这 3 株菌。伊曲康唑对这一全球机会性真菌的广谱活性表明，CLSI 和 EUCAST 方法可用于测试该药物对念珠菌的活性，结果高度可比。
